This is the story of Tom Dinwiddie, who was diagnosed with terminal cancer on April 2, 2012. This year, now age 69, he is officially six years cancer free.
The Diagnosis
Dinwiddie was diagnosed with metastatic stage 4 poorly differentiated neuroendocrine carcinoma of the pancreas. This type of cancer accounts for only 6% of the 55,000 annual pancreatic cancer diagnoses. In addition to a 5cm tumor in the head of the pancreas, he also had multiple tumors within his liver. He was told he only had a few months to live and that there were no treatment options.
Dinwiddie wouldn’t take that as an answer. He explained that at the rate cancer research was being completed, he was sure there was going to be an effective treatment for his diagnosis within the next five years. Dinwiddie told his doctor that all he needed was to stay alive those five years until a treatment was developed. He refused to lay there and wait to die. He refused to accept his prognosis. So, his doctor referred him to The Moffitt Cancer Center as well as Duke Cancer Institute. Dr. John Strickler from Duke took his case.
Unfortunately, further analysis by Strickler did not provide any more hope. Dinwiddie’s tumor was doubling in size every 4 weeks, with 97% of his cancer cells growing. Without treatment, his estimated survival was 3 months. It was recommended that his treatment regime should be focused on managing symptoms, and that he should try to focus on enjoying what time he had left.
Once again, Dinwiddie wouldn’t accept that answer. He planned to fight.
“If you’ve had a good life you’ll do anything to have another day.”
Hail Marry Pass
Heeding Dinwiddie’s wishes, Strickler prescribed FOLFIRINOX. This drug is certainly not the standard care for his diagnosis. It’s typically used for adenocarcinoma, a different form of cancer in the pancreas. However, the drug has shown to be efficacious for killing cancerous cells when they are actively dividing. Dinwiddie’s cells certainly fit this criteria and Strickler believed the treatment, as opposed to the typical prescription of etoposide and cisplatin, was worth a shot.
Strickler called it a Hail Mary pass.
In just one week Dinwiddie’s energy had improved and the swelling in his lower body had gone down. Two months after treatment, the tumor in Dinwiddie’s pancreas had reduced in size by more than 70%. Additionally, the tumors in his liver were smaller. Eight months later and his pancreatic tumor was only 1.4 centimeters and the tumors in his liver were all less than one centimeter.
Dinwiddie was then prescribed a pancreaticoduodenectomy to remove the remaining lesion on his pancreas and a right hepatectomy to remove the remaining lesions on his liver. These procedures were completed on January 23, 2013. On January 24, Dinwiddie declared himself cured.
Followup showed just a 2 millimeter focus of cancerous cells from what was removed in the pancreas and a microscopic foci in the tissue removed from the liver. This indicated Dinwiddie’s pathological response to the treatment was near-complete. Now, almost seven years later, he still has no evidence of disease.
FOLFIRINOX
Unfortunately, a clinical trial for FOLFIRINOX is not feasible because the patient population for this particular type of cancer is too small. However, Dinwiddie’s story still provides a beacon of hope for this treatment as a potential cure for this metastatic form of the disease.
Dinwiddie’s case is one of just two documented cases of successful treatment with FOLFIRINOX for this type of pancreatic cancer. Both of these cases are published here in the Journal of Gastrointestinal Cancer.
Life Now After Cancer
Dinwiddie says life now is much like it was before he was diagnosed with cancer and he’s grateful for every moment. There are only three things slightly different. One, is the Creon pill he takes with every meal which provides his body with the digestive enzymes his pancreas can’t produce anymore. Two, is his chemotherapy port I.D. card which he still keeps in his wallet. It’s a small reminder of his journey. And three, is the fact that Dinwiddie now volunteers with Pancreatic Cancer Action network (PANCAN).
He explains that when you first receive a devastating diagnosis, you’re filled with grief and fear and sadness. The outlook is dim for most patients. But there are people who make it through. Dinwiddie wants to be a voice of hope for those going through what he did, reassuring new patients that there is a chance in this fight. As someone whose been there himself, he’s able to have meaningful conversations with those newly diagnosed.
Dinwiddie says his outcome wasn’t a miracle. It was all thanks to science, Duke Cancer Institute, a brilliant physician John Strickler, and the determination he had to not take no as an answer.
You can read more about Tom Dinwiddie’s story and his experience with FOLFIRINOX here.
